OBJECTIVE: To assess the patient-reported use of caregiving, assistive devices and services among individuals with age-related macular degeneration (AMD) and evaluate the impact of visual impairment level on this use. METHODS: A new instrument, the AMD Health and Impact Questionnaire, was developed and pilot-tested for face validity and comprehensiveness. Following revisions, the survey was published on the Macular Degeneration Partnership's website. The study was approved by a central IRB and respondents provided consent before completing the survey. Responses were analyzed by category of visual impairment as determined by scores from the Visual Function Questionnaire near and distance scales (none/mild > 68, moderate = 43.6 to 67, severe £ 43.5). De-identified data were analyzed in SAS. RESULTS: Of 443 respondents, 39% were male and the mean age was 65 years. Respondents with mild visual impairment comprised 42% of the population, moderate and severe groups comprised 31% and 27%, respectively. Three-fourths of the population had AMD in both eyes. Use of paid and unpaid help was significantly associated with severity; 10%, 20%, and 71% of the mild, moderate, and severe respondents reported caregiver assistance (p <0.0001). Less than 11% of the respondents used assistive services (e.g., counseling, rehabilitation), but use was significantly higher as severity increased (p <0.05). For example, less than 6% of respondents with mild impairment but almost 77% of the most impaired respondents used counseling services. Use of devices (cane, magnifiers, computer software) also increased with severity (mean of 1.3, 2.1, and 3.8 devices used, p <0.0001). Using standard costs for devices and services and a national average for caregiver time, annual costs for mild, moderate, and severe respondents were $1,902, $3,553, and $20,570, respectively. CONCLUSION: There are substantial differences in service and device use with increased AMD severity. Delaying progression of AMD could result in considerable cost savings.